Are you related (by blood or by marriage) to a City employee or an elected/appointed City official?

*

Yes

No

9

If yes, who?

Name:

Department:

10

Have you ever been convicted of or pled guilty of any crime(s) (felony or misdemeanor)? (Applicants are not required to report convictions that have been expunged or sealed by a court of law)

*

Yes

No

11

If yes, describe each in full:

If yes, describe each in full:

A prior conviction will not automatically disqualify you from volunteering with the City of Goodyear. A false or incomplete answer may be grounds for not placing you or for dismissing you after placement. Failure to report arrests or convictions at any time during the term of your relationship with the City may render you ineligible to volunteer.

12

What special skills/certification/training or interests would you like to share that would be relevant to a particular job you’re applying for?

*

What special skills/certification/training or interests would you like to share that would be relevant to a particular job you’re applying for?

13

Describe relevant volunteer or work experience. Include names and telephone numbers of two references (other than family members).

*

Describe relevant volunteer or work experience. Include names and telephone numbers of two references (other than family members).

By my acceptance below, I certify that all statements made in this application are true and correct and that any false statements, misrepresentation, or omissions in the application may disqualify me for placement or result in dismissal at any time. I give permission for the City of Goodyear to conduct a background check on me, which may include a review of sex offender registries, MVD license check, fingerprinting, child abuse, criminal history records and substance abuse testing. I understand that, if appointed, my position is conditional upon the City receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability the City of Goodyear, its officers, agents, employees and volunteers, or any other person or organization that may provide such information. I further agree to release, hold harmless and indemnify the City of Goodyear, its officers, agents, employees and volunteers, from any and all liability or claims of injury or damages of any nature which may be incurred by me as a result of my voluntary participation in the City volunteer program. I understand that the work involved may include activities hazardous to the volunteer.

I understand and agree that I am providing volunteer services hours for civic, charitable, or humanitarian reasons, without promise, expectation, or receipt of compensation for services rendered. I am offering my services freely and without pressure or coercion; and am not otherwise employed by the City of Goodyear to perform the same type of services as those for which I will be volunteering.

I hereby grant and convey to the City of Goodyear all rights, title, and interest in any and all photographic images and video or audio recordings made by the City of Goodyear during the volunteer’s activities with respect to the Program, including but not limited to, any royalties, proceeds or other benefits derived from such photographs or recordings.

Due to the number of applicants received in correlation to the number of volunteer opportunities available that match any given skill set, the City of Goodyear many not be able to place all interested volunteers and is under no obligation to do so, however, you will be notified of your status. I understand that the City of Goodyear is under no obligation to accept all interested volunteers. The City reserves the right to terminate your volunteer assignment at any time or for any reason.

The City of Goodyear will not discriminate against any applicant because of race, color, religion, national origin, age, marital status, sexual orientation, disability, or any other reason prohibited by law.

19

I accept and agree to the terms stated above and apply to volunteer with the City of Goodyear.

*

Yes

Thank you for filling out an application to volunteer your time. We appreciate your willingness to give back to your community.

To receive a copy of your submission, please fill out your email address below and submit.